Persistent versus brief suicidal ideation subtypes in risk for adolescent suicide attempts

持续与短暂的自杀意念亚型有青少年自杀未遂的风险

基本信息

批准号：
9897612
负责人：
Regina Miranda
金额：
$ 39万
依托单位：
HUNTER COLLEGE
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-02-05 至 2023-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9897612
关键词：
Address Adolescence Adolescent Age Attention Characteristics Childhood Chronic Classification Clinical Research Clinical assessments Cognition Cognitive Communities Data Diagnostic Diagnostic and Statistical Manual of Mental Disorders Emergency Situation Event Failure Feeling suicidal Frequencies Future Grain Grant Hospitals Hour Intervention Interview Label Laboratories Length Life Longitudinal Studies Measurement Measures Mediating New York City Outpatients Parents Patient Self-Report Pattern Performance Population Prevention Recording of previous events Research Risk Risk Assessment Sampling Semantics Stimulus Structure Suicide Suicide attempt Suicide prevention System Techniques Teenagers Testing Thinking Time Training Urban Hospitals adolescent suicide attentional bias base clinical care clinical practice design follow-up high risk ideation improved multilevel analysis multimodality prevent recruit screening suicidal adolescent suicidal behavior suicidal morbidity suicidal risk

项目摘要

More suicide attempts are made during adolescence than at any other time in life. However, the measurement of suicidal ideation in adolescence has been hampered by a failure to understand the fine-grained aspects of suicidal ideation that predict the transition from suicidal thoughts to actual suicidal behavior. Recent research suggests that knowing how adolescents think about suicide – i.e., the form of suicidal ideation – in terms of characteristics such as frequency, duration, and pattern – may help predict not only whether an adolescent will go on to make a future attempt but also how soon they will do so, regardless of whether they have previously made a suicide attempt. However, current suicidal ideation measures and conceptualizations of suicide risk tend to ignore the form of an adolescent's suicidal ideation. This proposal for a renewal of a SCORE SC1 grant seeks to test 1) whether suicidal ideation that is characterized as occurring within a more persistent, long-standing episode is associated with higher short-term risk for a future suicide attempt over a 12-month follow-up period, compared to suicidal ideation that occurs in the context of a brief episode; 2) whether chronic suicidal ideation is characterized by more interference from and difficulty disengaging from suicide-related thoughts, as assessed by laboratory measures; and 3) whether this interference from and difficulty disengaging from suicide-related thoughts explains the greater risk of future suicide attempts among persistent vs. brief suicide ideators. These aims will be addressed via a longitudinal study of a diverse sample of 150 adolescents, ages 12-19, recruited from two New York City hospitals. Adolescents will be interviewed about the circumstances leading to their suicidal ideation and attempts using a newly developed semi-structured interview. They will also complete laboratory measures of their ability to disengage from suicide-related thoughts. Adolescents (and their parents) will be interviewed again 3 and 12 months later to assess for suicidal ideation and attempts made within the follow-up interval. This research will combine a newly developed semi- structured suicidal ideation interview with structured diagnostic interviews, tests of intellectual functioning, self- report assessments of cognitive biases, and objective measures of suicide-related cognitive biases. Data will be analyzed using multilevel modeling. Understanding patterns of suicidal ideation and their underlying cognitive profiles is a critical step in identifying targets for intervention to prevent suicide in this population. This research has the potential to change how suicide risk assessments are conducted in pediatric EDs by identifying which characteristics of suicidal ideation merit focus in clinical assessments with adolescents.

然而，青春期的自杀企图比一生中任何其他时期都多。由于未能理解自杀意念的具体细节，青少年自杀意念的发展受到了阻碍。自杀意念预测从自杀想法到实际自杀行为的转变。表明了解青少年如何看待自杀——即自杀意念的形式—— 频率、持续时间和模式等特征——不仅可以帮助预测青少年是否会继续进行未来的尝试，以及他们多久会这样做，无论他们之前是否有过然而，目前的自杀意念措施和自杀风险的概念。倾向于忽视青少年自杀意念的形式这个更新 SCORE SC1 的提案。格兰特试图测试 1) 自杀意念是否发生在一个更持久的、长期发作与未来 12 个月内自杀企图较高的短期风险相关随访期间，与短暂发作情况下发生的自杀意念相比；2) 是否是慢性的；自杀意念的特点是更多地受到与自杀相关的干扰并且难以摆脱通过实验室测量评估的想法；以及 3) 这种干扰和脱离困难是否存在与自杀相关的想法解释了持续自杀与短暂自杀的人未来自杀企图的风险更大这些目标将通过对 150 名青少年的不同样本进行纵向研究来实现，从纽约市两家医院招募的 12 至 19 岁青少年将接受有关该项目的采访。导致他们自杀意念和尝试使用新开发的半结构化的环境他们还将完成实验室测量，衡量他们摆脱自杀相关的能力。青少年（及其父母）将在 3 个月和 12 个月后再次接受采访，以评估自杀倾向。这项研究将结合新开发的半成品的构思和尝试。结构化自杀意念访谈、结构化诊断访谈、智力功能测试、自我评估报告认知偏差的评估以及与自杀相关的认知偏差的客观测量数据。使用多层次模型来分析自杀意念的模式及其背后的原因。认知概况是确定预防该人群自杀的干预目标的关键一步。这项研究有可能改变儿科急诊室自杀风险评估的方式确定自杀意念的哪些特征值得在青少年临床评估中重点关注。